The region's combined population was 890,121 people as of the 2010 census. Many of the place names in the region are from the Delaware Indians (the self-named Lenape peoples) and the powerful Susquehannock nation, an Iroquoian people who dominated the Susquehanna valley in the 16th and 17th-century when Dutch, Swedish and French migrants were exploring North America and founding settlements along the Atlantic Seaboard.

The Coal region or Pennsylvania Anthracite region or fields is home to the largest known deposits of anthracitecoal found in the Americas, with an estimated reserve of seven billion short tons.[3] It is these deposits that provide the region with its nickname. The discovery of anthracite coal was first made in the Schuylkill County by a hunter in 1791, 16 years after the North Field saw its first mine.

The population of the Amerindian tribesmen of the Susquehannock nation was reduced 90 percent[4] in three years of a plague of diseases and possibly war,[4] opening up the Susquehanna Valley and all of Pennsylvania to settlement as the tribe was all but eliminated, the survivors adopted[4] into a quasi-enemy but related Iroquois by formal treaty in 1870.[4]

Settlement in the region predates the American Revolution: both Delaware and Susquehannock power had been broken by disease and Indian-on-Indian warfare before the British took over the Dutch and Swedish colonies and settled Pennsylvania. The first discovery of the anthracite coal occurred in 1762, and the first mine was established in 1775 near Pittston, Pennsylvania.[5] In 1791 Anthracite was discovered by a hunter atop Pisgah Ridge, and by 1792 the Lehigh Coal Mining Company began producing and shipping coal to Philadelphia via Mauch Chunk from the Southern Anthracite Field and Summit Hill, Pennsylvania built atop the line between Schuylkill County and what would be renamed Carbon County. By 1818, customers fed up with the inconsistent mismanagement, leased the Lehigh Coal Mining Company and founded the Lehigh Navigation Company: construction soon began for navigation; the locks and dams on the Lehigh Riverrapids stretches, later known as the Lehigh Canal (finished in 1820).

In 1822, the two companies merged as the Lehigh Coal & Navigation Company (LC&N) and by 1824 were turning heads with the volume of coal shipped down the Lehigh and Delaware Canals. Meanwhile, three brothers had similar ideas from near the turn of the century, and about the same time began mining coal in Carbondale, 15 miles (24.1 km) northeast of Scranton, but high enough to run a gravity railroad to the Delaware River and feed New York City via the Delaware and Hudson Canal. Pennsylvania began the Delaware Canal to connect the Lehigh Canal to Philladelphia and environs, while funding to build a canal across the Appalachians' Allegheny Mountains to Pittsburgh. In 1827, LC&N built the second railroad in the country, a gravity railroad from Mauch Chunk Switchback Railway, running Summit Hill to Mauch Chunk.

Population rapidly grew in the period following the American Civil War, with the expansion of the mining and railroad industries. English, Welsh, Irish and German immigrants formed a large portion of this increase, followed by Polish, Slovak, Ruthenian, Ukrainian, Hungarian, Italian, Russian and Lithuanian immigrants. The influence of these immigrant populations is still strongly felt in the region, with various towns possessing pronounced ethnic characters and cuisine.

The anthracite mining industry loomed over the region until its decline in the 1950s. Strip mines and fires, most notably in Centralia remain visible. Several violent incidences in the history of the U.S. labor movement occurred within the coal region as this was the location of the Lattimer Massacre and the home of the Molly Maguires.

The Knox Mine Disaster in 1959 served as the death knell for deep mining; almost all current anthracite mining is done via strip mining. Tours of underground mines can be taken in Ashland, Scranton, and Lansford, each of them also having museums dedicated to the mining industry. Also evident are patch towns, small villages affiliated with a particular mine. These towns, with populations less than 500, were owned by the mining company. Though no longer company owned, many hamlets survive; one of them, the Eckley Miners' Village, is a historical park owned and administered by the Pennsylvania Historical and Museum Commission, which seeks to restore patch towns to their original state.

^Healey, Richard (2005) "The Breakers of the Northern Anthracite Coalfield of Pennsylvania", 'Vol. 1, Major breakers prior to 1902'. Dept of Geography, University of Portsmouth, Portsmouth. quote="Northern Anthracite Coalfield of Pennsylvania" (implying there is a Southern Anthracite Coalfield of Pennsylvania)